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脊柱减压可改善腰椎管狭窄症患者的步行能力。

Spinal decompression improves walking capacity in patients with lumbar spinal stenosis.

作者信息

Andersen Mikkel Ø, Carreon Leah Y, Hummel Stefan, Smith Elisabeth C, Andresen Andreas K

机构信息

Center for Spine Surgery and Research, Lillebaelt Hospital, Kolding, Denmark.

Institute of Regional Health Research, University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark.

出版信息

Brain Spine. 2025 Apr 28;5:104268. doi: 10.1016/j.bas.2025.104268. eCollection 2025.

Abstract

INTRODUCTION

Lumbar spinal stenosis (LSS) is a degenerative condition causing back and leg pain, limiting walking due to neurogenic claudication. It affects 9-11 % of the population, rising to 47 % in those over 60, with cases expected to increase as the population ages. Non-surgical treatments are considered first-line options, although their effectiveness remains uncertain. Decompression surgery is still commonly performed for severe cases, even though a review comparing conservative treatments with surgical procedures, including spinal decompression, found no clear superiority of surgery. In Denmark, LSS accounts for 35 % of spinal surgeries in adults.

RESEARCH QUESTION

Does spinal decompression improve walking distance and gait speed in patients suffering from LSS?

METHODS

Consecutive patients scheduled for decompression due to spinal stenosis enrolled at a regional spine centre. Timed walking distance (maximum of 1000m) was performed at baseline and at 3-, and 12 months post-op.

RESULTS

One hundred and one patients were included in the study, mean age was 70.7 years, 77 % were female, with 90 % having had symptoms for more than 6 months prior to surgery.Walking distance (123.9m-791.1m, p < .001) and speed (0.91 m/s to 1.17 m/s, p < .001) improved at one year after surgery.

DISCUSSION AND CONCLUSION

Patients with severe walking impairment caused by spinal stenosis experienced substantial improvement of both walking speed and walking distance at all follow-up time points after undergoing spinal decompression.

摘要

引言

腰椎管狭窄症(LSS)是一种退行性疾病,可导致腰腿痛,因神经源性间歇性跛行而限制行走。它影响9%至11%的人群,在60岁以上人群中这一比例升至47%,预计随着人口老龄化,病例数还会增加。非手术治疗被视为一线选择,但其有效性仍不确定。尽管一项比较保守治疗与手术治疗(包括脊柱减压)的综述发现手术并无明显优势,但减压手术仍常用于严重病例。在丹麦,LSS占成人脊柱手术的35%。

研究问题

脊柱减压能否改善腰椎管狭窄症患者的行走距离和步态速度?

方法

在一个地区脊柱中心招募因椎管狭窄计划进行减压的连续患者。在基线、术后3个月和12个月时进行定时行走距离(最长1000米)测试。

结果

101名患者纳入研究,平均年龄70.7岁,77%为女性,90%在手术前有症状超过6个月。术后一年,行走距离(123.9米至791.1米,p<0.001)和速度(0.91米/秒至1.17米/秒,p<0.001)均有所改善。

讨论与结论

因椎管狭窄导致严重行走障碍的患者在接受脊柱减压后,在所有随访时间点的行走速度和行走距离均有显著改善。

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